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Studies on circulating immunoreactive calcitonin in low birth weight infants during the first 48 hours of life
Insights
In low birth weight infants, calcitonin secretion increases in the early neonatal period. This contributes to early-onset neonatal hypocalcemia, impacting calcium levels.
Area of Science:
- Neonatology
- Endocrinology
- Pediatric Biochemistry
Background:
- Neonatal hypocalcemia is a common concern in low birth weight infants.
- The role of calcitonin in early neonatal calcium homeostasis is not fully understood.
Purpose of the Study:
- To investigate the sequential changes in serum calcitonin (iCT) and parathyroid hormone (iPTH) levels in low birth weight infants.
- To determine the relationship between these hormones and serum calcium (Ca), magnesium (Mg), and phosphorus (P) levels during the first 48 hours of life.
- To elucidate the contribution of calcitonin secretion to early-type neonatal hypocalcemia.
Main Methods:
- Serum samples were collected from 16 low birth weight infants at five time points (1-48 hours).
- Levels of immunoreactive calcitonin (iCT), immunoreactive parathyroid hormone (iPTH), Ca, Mg, P, and total protein were measured.
- Statistical analysis, including correlation studies, was performed.
Main Results:
- Serum calcium levels significantly decreased in the first 12-14 hours of life.
- Serum iPTH levels showed a steady increase from 1-2 hours to 44-48 hours.
- Serum iCT levels, initially undetectable in most infants, markedly increased at 12-26 hours and correlated negatively with gestational age and serum calcium, and positively with serum iPTH.
Conclusions:
- Calcitonin is secreted in the early neonatal period in low birth weight infants.
- This calcitonin secretion is a significant factor in the development of early-type neonatal hypocalcemia.
- Findings suggest a complex interplay between calcitonin, parathyroid hormone, and calcium regulation in this vulnerable population.
Abstract:
Serum immunoreactive calcitonin (iCT), serum immunoreactive parathyroid hormone (iPTH) and serum Ca, Mg, P and total protein levels were determined sequentially at 5 given periods of time from 1 to 48 h of age in 16 low birth weight infants. Mean +/- SD serum Ca levels decreased from 8.99 +/- 0.79 mg/100 ml at time 1--2 h to 7.00 +/- 0.51 mg/100 ml at time 12--14 h; there was a small further decrease at time 22--26 h: 6.79 +/- 1.07 mg/100 ml. There was no significant change in serum Mg, P or total protein during the same periods of time. Serum iPTH levels increased steadily from time 1--2 h to time 44--48 h reaching above normal range values. Serum iCT levels were non detectable (less than 150 pg/ml) in 11 among 15 infants at time 1--2 h. A marked increase in mean +/- SD serum iCT levels was observed at time 12--14 h (1850 +/- 872 pg/ml) and time 22--26 h (1462 +/- 806 pg/ml) followed by a decrease at time 44--48 h. A negative correlation was found between serum iCT levels and respectively gestational age (p less than 0.01) and serum Ca levels (p less than 0.01) at time 22--26 h while serum iCT levels correlated positively with serum iPTH levels (p less than 0.05). Evidence obtained from this study indicates that a secretion of calcitonin takes place during the early neonatal period in low birth weight infants and that this secretion is a contributing factor of the socalled "early-type" neonatal hypocalcemia.